The Physical Therapy profession is expansive in its scope covering specialized populations, diagnoses, method formulas and models of practice.
A Physical Therapy professional’s style has not been specified by the American Physical Therapy Association, our main governing body. This is good because we have latitude to practice medicine. Have you considered whether you as a clinician focus on diagnosis or treatment? The answer holds importance for you, your patients and our profession.
How does ‘diagnosis focus’ look professionally?
The clinical exam (and follow-up exam) will include the required and necessary clinical tests for the given referral diagnosis – in short, a standard exam. A diagnosis is then applied like a label. The physical therapist’s assessment reviews exam findings, without analyzing associated factors. The patient is given a sheet of general exercises. That’s it – clear cut, clean, and complete. The physical therapist has performed all he or she is obligated to do – to apply tests which any reasonable physical therapist would use for the same referral diagnosis and give general exercises.
Is that all we as physical therapists do?
Many in the medical community believe such things, as do many patients. If a patient arrives believing physical therapist will not take away their pain or restore their full function, do we change their opinion merely through the actions of examination and diagnosis? Patients are always being given diagnoses! Every other provider they see labels them with a diagnosis – do we as professionals enhance a person’s care by diagnosing a condition specifically and giving general exercises? Is that the purpose of the Doctorate of Physical Therapy degree – to prove to the medical community we can diagnose accurately? Practicing in such ways requires low investment of time and effort and will save time…for the provider. We are the musculoskeletal experts – so when we diagnose and apply a general treatment plan, how are we demonstrating our expertise?
How does a ‘treatment impact’ focus look professionally?
The exams will still include relevant clinical tests – in addition to observations or functional tasks employed by the physical therapist to reproduce the patient’s dysfunction. The diagnosis may be the same as for a ‘standard’ exam but the assessment includes a critical analysis of the relevant factors. (ie, the assessment is not a regurgitation of exam findings or a diagnosis label standing alone). The exam ‘extras’ guide the tailored treatment plan as much as the ‘standard’ tests – and in subsequent visits, the plan is modified (often at each exam). This approach requires more provider effort, thought, planning and analysis – and time.
In the end, the ‘treatment impact’ focus has greater potential for full pain-relief and function restoration – because patients present with more (stuff) than do subjects in research studies. A ‘diagnosis focus’ physical therapy practice will meet all obligations and requirements defined by our practice and by research studies. How often do patients present with clearly defined diagnoses, as subjects in research studies?
This ‘treatment impact’ approach also leads to more provider fulfillment since you as a provider use your knowledge and skills to improve a patient’s life, not just diagnose and apply general treatments. Let’s overcome the assumptions of the medical community and patients – let’s excel and advance our profession.
Let’s apply our expertise!
Stephen Seward, PT
For additional blog posts and information on career enhancement and young PT professionals be sure to visit Stephen’s blog: “Advance Your Physical Therapy Career”
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